MEDICARE: WILLIAM CHARLES GREENBERG APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	CNS 9437804	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00056190	OTHER	MA	RAIL ROAD MEDICARE

General Provider Information

NPI Number	:	1821013566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM CHARLES GREENBERG APRN

Provider Business Mailing Address
First Line	:	7301A W PALMETTO PARK RD
Second Line	:	SUITE 106-C
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3409
Country	:	US
Telephone Number	:	561-391-4669
Fax Number	:	561-391-1815

Provider Business Practice Location Address
First Line	:	7301A W PALMETTO PARK RD
Second Line	:	SUITE 106-C
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3409
Country	:	US
Telephone Number	:	561-391-4669
Fax Number	:	561-391-1815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	11/02/2016

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